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NPI Code Detail

MEDICARE: GROW WELL CLEVELAND

MEDICARE: GROW WELL CLEVELAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1102L00000XPsychoanalyst
2101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295244317
Entity Type Code : Organization
Provider Name (Legal Business Name) : GROW WELL CLEVELAND
Provider Business Mailing Address
First Line : 3000 BRIDGE AVE STE 4
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3086
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3000 BRIDGE AVE STE 4
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-3086
Country : US
Telephone Number : 216-282-3838
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : JESSICA D SEN
Credential :
Telephone Number : 216-282-3838
Provider Enumeration Date : 09/20/2017
Last Update Date : 03/18/2026

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Directions to “GROW WELL CLEVELAND ” Practice Location

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